If you’re depressed, the right medication can change your outlook on life. But for some people, the side effects of antidepressants can be unpleasant or even intolerable. Find out what drawbacks you might expect and how to keep them from ruining your recovery...

For the 19 million Americans who develop depression each year, antidepressants can be a huge help. About 11% of American women now take them, either on their own or to enhance the results of psychotherapy.

But like any medication, they come with side effects, ranging from mild to serious. For some people, side effects of antidepressants affect quality of life; for others, they make the drug intolerable.

“Antidepressants are very safe, but ... there are risks people need to be aware of,” says Michael D. Banov, M.D., medical director of Northwest Behavioral Medicine and Research Center in Atlanta, Ga., and author of Taking Antidepressants(Sunrise River Press).

Many women worry about the side effects of antidepressants. Here’s how to get all the benefits while minimizing drawbacks.

Medication Strategies to Reduce Side Effects The number and severity of antidepressant side effects varies widely between people, Banov says. Some experience several at once because their bodies metabolize the medicine more slowly. Others don’t develop any.

The good news is that many side effects are minor, temporary or both.

“A lot of people develop very mild side effects the first couple of days they take an antidepressant, but these [often] go away after a few days,” Banov explains.

Others disappear once your body adjusts to the medication, usually in about 1-2 weeks.

However, side effects that linger more than 2-4 weeks are less likely to ease.

Some doctors recommend starting on the lowest dose possible and gradually increasing dosage until symptoms improve. This gives the body time to adjust to the medicine.

However, researchers aren’t sure how often suicidal thoughts are caused by the medication itself. In fact, rates of suicide have dropped since Prozac and other selective serotonin reuptake inhibitors (SSRIs) hit the market, according to a 2005 UCLA study.

“Because depression itself is associated with suicidal thoughts, it could be that the depression is worsening before the medication has a chance to kick in,” Banov explains.

Expert advice: Talk with your doctor about the possibility of suicidal thoughts or behavior, alert friends and family, and have a plan in case you start thinking about suicide, Banov recommends.

“Make sure everyone is aware of the potential risk,” he says. “It’s only when you don’t realize this can happen and don’t associate it with the medicine that it does.”

If you do start thinking about suicide, call your doctor, who can taper you off the medicine safely and decide whether you need to switch to another medication, possibly in the same class.

A different medicine in the same class might alleviate the problem, especially if you’re taking SSRIs.

“If you don’t do well on one SSRI, that doesn’t mean you [won’t] respond to another,” Kurian says

But never stop the medicine on your own, which could make your illness worse.

You could experience “discontinuation syndrome” – a range of symptoms, such as anxiety, restlessness, a sense of unease and even worsening depression.

“The longer you’ve been on the antidepressant, the more likely it is that you’ll develop discontinuation syndrome if you stop cold turkey,” Kurian cautions.

Sexual problemsAbout 25%-80% of people taking antidepressants experience sexual dysfunction, according to a 2009 research analysis published in the Journal of Clinical Psychopharmacology.

Men complain about delayed ejaculation or erectile dysfunction, but women report decreased desire and an inability to have an orgasm.

Although any antidepressant can trigger sexual problems, they’re more commonly associated with SSRIs, such as Prozac, Zoloft and Paxil, Kurian says. Wellbutrin (bupropion), which works on different brain chemicals, is the least likely to cause sexual issues.

Expert advice: If you experience a decreased interest in sex, first make sure it’s really the medicine causing the problem, Banov advises.

Your doctor can help rule out other conditions, such as low testosterone or estrogen levels, or a disease like type 2 diabetes or a thyroid problem – all of which can affect sexual functioning.

“If I determine that it’s a drug side effect and bothers the patient, I typically switch medicines,” Kurian says.

Another option is to decrease the dosage, lower the dosage and add a second antidepressant.

For example, “If you take Prozac and it really helps, but you’re having side effects, we may lower the dosage and add bupropion (Wellbutrin),” Banov says.

Because the two target different brain chemicals, they may work better as a pair. The trade-off: The second drug may introduce another set of side effects.

Another treatment is Viagra (sildenafil), even though the FDA hasn't approved it for use in women. It eased antidepressant-related sexual problems in 28% of the women who took it, according to a 2008 University of New Mexico study published in the Journal of the American Medical Association.

But an expanding waistline also may be triggered by a better mood, as patients regain the appetite they lost due to depression.

Expert advice:Your doctor may switch you to an antidepressant less likely to affect weight, such as Wellbutrin.

You can also try cognitive behavioral therapy or behavioral activation therapy – treatments that focus on changing behaviors to address problems, such as overeating or not exercising, Kurian says.

Sleep problemsOne of the side effects of antidepressants is sleep problems. The same Harris survey found that 66% of depressed people with insomnia believe the problem either began or persisted after they started antidepressants.

While any antidepressant can trigger insomnia, it’s more likely to occur if you take certain SSRIs or Wellbutrin.

Expert advice:Take your antidepressant in the morning instead of at night.

Your doctor may also decrease your dosage.

Yet another option: Talk to your doctor about temporarily taking a sleep medication.

“Adding another medicine to treat a side effect is our least favorite option,” Banov says. “But in some cases, this is what you have to do.”

Talk to Your DoctorWhen prescribed an antidepressant, a patient should continue an ongoing conversation with her doctor about symptoms, Kurian adds.

Here’s what to cover in that conversation:

1. Ask what symptoms the medicine could trigger.

2. Be open about all the symptoms you’re experiencing.

Often, patients don’t tell their doctors enough. A 2010 study published in the Journal of Clinical Psychiatry found that the average number of side effects patients actually experienced was 20 times as high as the number noted in their medical records.

But you don’t have to do all the talking.

Your doctor should ask targeted questions about any side effects of antidepressants, especially in the first few weeks of treatment.

“If a doctor just asks a patient, ‘Are you having any side effects?’ she’s more likely to say no than if asked about specific ones, such as nausea or headache,” Kurian says.

3. Ask your doctor to help you make a “risk-benefit analysis” that weighs improvements in your quality of life against bothersome symptoms.

If the drug is helping you feel and function better, Kurian says, some side effects could be a trade-off you’re willing to make.

How Much Do You Know About Depression?Despite all the progress in diagnosing and treating this disease, many people still are in the dark when it comes to understanding depression. How much do you really know? Take this depression quiz, which includes information from Lawson Wulsin's, M.D., book, Treating The Aching Heart, and see how well you know fact from fiction.

The information contained on www.lifescript.com(the "Site") is provided for informational purposes only and is not meant to substitute for advice from your doctor or health-care professional. This information should not be used for diagnosing or treating a health problem or disease, or prescribing any medication. Always seek the advice of a qualified health-care professional regarding any medical condition. Information and statements provided by the site about dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. Lifescript does not recommend or endorse any specific tests, physicians, third-party products, procedures, opinions, or other information mentioned on the Site. Reliance on any information provided by Lifescript is solely at your own risk.